Why I Baby-Wear

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I’m a pretty hardcore baby-wearer. I don’t own a pram or pushchair. I wore Nookie until she was three, and now Smushface spends hours every day in the sling. She takes most of her naps in the sling. I have a growing collection of various slings; a ring sling, a few Mei Tais, a Moby wrap and my newest addition, a podaegi. I just love baby-wearing. Why? Here’s why:

  • The closeness. I love having my babies near me. I love their smell. I love being able to just put my head down and kiss them on the head. I love cuddling them. I can’t imagine having them away from me in a pushchair. They should be right there, snuggled into my chest.
  • Breastfeeding. I can feed Smushface in most of my slings. It’s a bit of a tight squeeze, but I can. So I don’t have to stop whatever I’m doing, sit down and feed my baby. I just whip my boob out, stick it in her mouth, and then resume whatever I’m doing. Walking the dogs, cooking dinner, playing with Nookie… I’ve done them all whilst feeding Smushface in the sling. Having a baby around is so much easier when you don’t have to be pinned to the sofa feeding them! I also never worry about nursing in public because no one can see a thing!
  • Practicality. Getting on a bus with a pram? Putting a pram in a small car? Storing a pram in a tiny house? Getting a pram into any shop! Fuck that. I can’t actually describe to you how much easier using a sling is. I used a pram with Nookie for about three months and hated it (as did she!). They’re fucking cumbersome things. Granted, there are a few occasions when having a pushchair is easier. Baby-wearing in hot weather is a bit sweaty, for example. But a sling is more practical in about nine out of ten situations I would say.
  • Price. Unless you buy a pram or pushchair second-hand (like I did with Nookie), I understand they cost a pretty penny. And their resale value is negligible. Granted, some slings are hugely expensive. But they don’t have to be. My favourite Mei Tai cost £50. And when I’m done with it it’ll probably sell for about the same amount of money. I’ve bought and sold numerous slings as I’ve tried them out, and they’ve always sold for about the same amount as I bought them for so long as they’re well looked after.
  • Getting on with daily life. There aren’t many things I haven’t done whilst baby-wearing. Cooking, cleaning, walking, climbing with Nookie, ironing, mowing the lawn, planting trees, walking the dogs, putting up a tent… hands-free parenting! And the added weight must be making me stronger and fitter. Double bonus!
  • Aesthetic. Have you seen some slings? They’re beautiful! My podaegi is just gorgeous. My Maya wrap Mei Tai is so boho and pretty. Some of the woven wraps out there are made of the most intricate, beautiful fabrics. I love matching my slings to my outfits and wearing them. They look awesome!

Overall I baby-wear because it makes life, especially with an older child, much MUCH easier. I can’t imagine how I could do so many of the things I do without my slings. I don’t have to sacrifice any of my daily activities for my baby. She just fits into our lives.

Community

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A few recent events have really made me think a lot about community. Or rather, the lack of it in this age. We each live in our own little bubbles, isolated from each other, surrounded by people living in theirs. We go about our daily business alone except for our family, whilst our next door neighbours go about theirs. We’re probably doing very similar, or even the same, activities. But we do it in isolation. The more I think about it, the more crazy it seems.

Going to the home-education camp recently really brought it home to me. Being surrounded by close friends, sharing the load, always having someone there… it was amazing. The kids would wake up and all go off together on their adventures, whilst the adults chatted while we cooked and got on with the few chores that camping entails. There was always someone there to hold the baby. If someone was doing a load of washing up they would take everyone’s. There was always someone with some spare hot water for a cup of tea, or a bit of leftover dinner so someone wouldn’t have to cook. We shared, we cooperated and most importantly of all, we were a community. If only it could have lasted forever…

I knew that coming home would be a culture shock. But it’s not just that. This way we live seems crazy to me. Why don’t we know our neighbours?! Why are we all so reluctant to come together and share? We’re all people aren’t we? We all want similar things in life. What is this sickness that is our culture?

Over the last few months I’ve had the great pleasure to be part of a wonderful community of women on Facebook. What started off as a group to support us through the process of Intuitive Eating and healing ourselves of a lifetimes damage when it comes to body image, has become so much more. Being amongst these women, sharing our innermost feelings and problems… it’s been an inspiration. And an invaluable emotional resource the like of which I’ve never known before. Here are women who are genuinely trying to help each other in any way they can. Whether it’s a virtual hug, a listening ear, someone to call in the middle of the night when you’re feeling down, practical help… they’re there. They’re always there. And not in the platitudinous, empty “we’re always here” that you often get from well-meaning people, but know they don’t actually mean it. In a very real, going-that-extra-mile kind of way!

But it’s made me realise what we’re missing in society. Why do we live the way we do? Isolated. Why don’t we share? Why is it that I share a garden with two neighbours and we each have our own play equipment that we would never consider sharing? Why couldn’t the more fortunate members of the community come together to help those in need? Why are we relying on the state?! Why can’t we rely on each other?! It’s insane.

I long for a tribe: a community. If only my friends and dear family had the money to buy our own plot of land and build our own community on it. It would be wonderful!

But it has got me to thinking about where we live, and what I could do to make it better. Not waiting for someone else. Actually doing something. Am I brave enough to break outside of society’s recipe?

The Best Bits of Home-education

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It’s the little conversations. That’s where the real learning happens. Yes we do learning activities. We cook and do experiments and paint pictures and have trips out to museums. These things all have their value. But the chats in the car or whilst on the train; the running commentary about life discussed as we walk to the shop to buy sweets… this is where the questions arise and the explanations are given. Informal, relaxed, about things that matter there and then.

Why do those plants look spiky?

Why do people drop litter?

Why do workmen dig up the road?

Learning. Happening. Constantly. Language developed. Curiosity fed. The web of knowledge expanded and connections made in unknown ways. Known only to her. Meaningful only to her. Some things will be forgotten. Many things will be remembered. But it’ll be what’s relevant to her, not what can be assessed by another.

This is learning.

A New Beginning

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So lately I’ve been thinking a lot. About life, about privacy, about my reasons for blogging, and about what I want this space to be. And it seems to me that my blog had become stagnant. With the current demands of my life I haven’t really been tending it, and it wasn’t serving me the way it used to. I needed a change.

So, I’ve decided to make my past posts private for now, redesign my blog space, and start anew. I think I’ll be focusing more on radical unschooling, rants and reflection, rather than the daily life stuff. But we’ll see. I also won’t be posting recognisable pictures of my children anymore, for reasons of privacy. I might archive some of my old posts at some point, when I get time, but for now I’ll keep them private. I really need a fresh start and a clean slate.

So to my followers, I hope you stick with me. And to new readers, hello. Welcome to my blog.

What Psychiatric Nurses Do (Part Twelve – Mentoring and Supervision)

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This is part twelve (the final part!) of my series on what psychiatric nurses do. You can read the other parts of the series here.

Teaching and mentoring students and newly qualified nurses was my favourite part of psychiatric nursing. I loved when we had students on the ward, especially first-years. Their bright-eyed, naive, blank-slate approach, and the opportunity ahead of them… It was exciting helping them through their journey. 

Basically, all the staff on the ward are responsible for guiding and teaching students and new nurses. There’s so much they need to learn, and students will spend time with various members of the team, getting experience in all the aspects of running and working on a ward. But each student and preceptor (a newly qualified nurse on their initial introduction to the job) will be allocated a mentor and co-mentor who are responsible for overseeing their learning and ensuring they’re meeting all their learning objectives. 

Becoming a mentor is a complicated business. I undertook the training as soon as I was able to. You have to enrol at university to complete the mentorship training, which is paid for by your employer. Then you attend university one day per week for a number of months, or some people do an intense course of a few days a week for just a few weeks. You attend lectures and have to do coursework, as well as working with a student, under supervision, at work. Once you’ve passed your course, you then have to co-mentor three students before you can be signed off as a mentor and have your own students. You have to complete top-up training every year, and maintain a portfolio of your work with students. 

To be a mentor to preceptors is more complicated, and at the place where I worked only Band 6 nurses (most nurses are Band 5) could mentor preceptors. 

Unfortunately, despite passing my training I only had the opportunity to co-mentor one student, as soon after I left university I went on maternity leave. But I had the pleasure of working closely with lots of students and preceptors throughout my short career. I would let them shadow me, teach them about writing care plans and doing assessments, observe them giving injections and taking physical measurements, and talk to them about their experiences and issues they were having. It was very rewarding and interesting. 

Not all nurses are so interested in students and preceptors. I had some awful experiences as a student myself, with disinterested staff who couldn’t care less about teaching students and were sometimes downright hostile! And I guess that’s one of the reasons I was always so keen to be there for students when I was a nurse myself. But overall, all nurses are professionally obliged to assist students and preceptors with their learning and most do. 

Mentors basically work closely with their allocated students, working with them directly ideally a couple of times a week, matching shifts. Each student will have different learning objectives based on where they are in their training. First years generally need to focus on basic things like interpersonal skills, taking physical measurements, and general learning about healthcare, whereas third years need to focus on the more advanced aspects of nursing like shift leading, assessment and staff management. The mentor will closely monitor what the student is learning, meet with them regularly to identify learning opportunities, and assess their progress throughout the placement. The mentor is also responsible for noticing and addressing any issues with the student, such as areas they’re struggling, problems with attendance, etc. Sometimes it may be necessary to inform the university if the student is not meeting their obligations, and mentors can refuse to give the student a pass for the placement if serious issues arise. Mentors are basically teachers and assessors, working in tune with the university, for the duration of the student’s time with them. It’s a lot of responsibility. 

The final part of the job of a psychiatric nurse I just want to touch on is supervision. All nurses, as part of their professional development, are supposed to access supervision. Supervision is basically a form of informal counselling with a more experienced nurse who you get along with. Soon after commencing employment you have to approach a nurse you’re comfortable with and ask them to provide supervision. It shouldn’t be a nurse who works in the same place you do. It could be a nearby ward nurse or community nurse or lower manager. The supervisor/supervisee relationship is confidential and you’re supposed to meet at least once per year. Supervision is basically intended to discuss any issues that have arisen for you at work or even in your personal life, and get support. The supervisor might listen to problems you’re having, suggest things you could do or places you could access services to assist you, or help you work through issues you’re having. Supervision is protected time which you’re allowed to take whenever you need it, fully paid. 

In practice, in my experience, supervision wasn’t accessed nearly as often as necessary. I myself rarely accessed it. There just wasn’t time, and trying to match schedules with someone on a another ward was a logistical nightmare! However you are professionally obliged to have supervision, as it’s part of professional development criteria. 

So that’s it. Twelve sections of description of what exactly psychiatric nurses do. Told you it was a diverse job! It’s a hard, stressful job with little reward and high-risks. Those that do it need a medal! Kudos to all my ex-colleagues. I couldn’t do it anymore, but they’re still there, day after day, putting their heart and energy into helping others. I take my hat off to you. X

What Psychiatric Nurses Do (Part Eleven – Discharges and Training)

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This is part eleven of my series on what psychiatric nurses do. You can read the other parts of the series here.

When patients are coming to the end of their stay on a ward, a number of things will happen. The nursing team will start to make plans for the patient’s transition back home days or even weeks before discharge. Community teams will be spoken to and invited to meetings. Family members may be consulted. For some patients, arrangements for housing may need to be made by referral to housing agencies or places at rehabilitation centres may need to be found. It all depends on the patient. For some patients who are in hospital for a matter of days, transition home may be simple: speak to the family, arrange community follow-up, order medication, done! But for some patients who have been in hospital many months and who will need significant community support, it may take weeks of planning to put everything in place. 

Between them the Consultant, community team (if there is one) and nursing team will coordinate the discharge. All patients have to receive at least 7 days of follow-up post-discharge from an inpatient psychiatric ward. This is a legal requirement. For those patients who do not have a designated community nurse, follow-up is undertaken by the Crisis Team, Discharge Liaison Team or something like it, depending on the area. A nurse will meet the patient prior to discharge and arrange a time/day for a home visit, support phone call, etc. 

A day or two before discharge a nurse will need to ensure medication has been ordered. Then there will usually be a ward review where the doctor agrees to the discharge. If the patient is sectioned, the Consultant needs to complete a form officially discharging them from the section. Then it’s a whole stack of paperwork and little jobs for the nurse to look forward to. 

Discharging patients on the ward I was on started off as a simple paper exercise. But as the computer system replaced the paper one, the number of clerical tasks multiplied to the point where discharges became a very time-consuming procedure. Prior to discharge the nurse needs to weigh the patient, complete a discharge paper and give it to the patient, ask them to complete a satisfaction survey and give them their medication. Then they need to complete a discharge risk assessment, discharge the care plans, complete numerous other little forms, cross the patient off numerous boards, remove the patient from the bed on the computer system, make a case-note entry…. you get the idea! A huge long actual printed list of little tasks you need to do, and if you miss anything you get a telling off from management. If you have two or three discharges in a shift (not unusual), these discharges can end up taking half your day up!

Voluntary patients can, of course, also discharge themselves against medical advice if a doctor or nurse has seen them and are satisfied they’re not risky enough to be detained. The patient has to sign a form agreeing that they are leaving against the advice of the ward staff. This is fairly unusual in these risk-averse, compensation-culture times, but it does happen occasionally.  

In addition to doing the actual job of a psychiatric nurse, there is always mandatory training to be complicated. It gets to be a bit of a pain. Things like fire training have to be done every year – a computer program or short lecture. Managing violence and aggression refreshers need to be done every 18 months or so – a 2 day course which, if you miss, you have to do the 5 day full training all over again. Some things like accepting mental health act papers only need to be completed once. But on top of these there are always little updates to knowledge to be completed, most of which is on the computer. It’s very hard to keep up with these around all the other work that needs doing. And management nag about people completing them all the time, as they themselves are getting ear-ache from their managers about staff keeping their training up-to-date. 

As part of a nurse’s professional development we can also choose to undertake further training. University courses are available and fully paid-for by the employer. You have to go through a fair amount of paperwork to get onto these courses, and the employer has to be satisfied it’s worthwhile them paying for it, but they will. Instead of working you will spend so many of your work days at university. Unsurprisingly nurses like doing this! Courses are generally things like psychotherapy, counselling skills, managing medication, specialism in acute ward nursing, mentorship – which is one I did at the nearby university one day per week. The courses nurses do can add to their professional qualification – for example if you have a diploma like I have, you can add up the ‘points’ from extra training, over time, to top-up to a degree. 

Which leads me onto my final discussion: teaching and mentoring students and new nurses. 

What Psychiatric Nurses Do (Part Ten – Personal Physical Care and Clerical Duties)

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This is part ten of my series on what psychiatric nurses do. You can read the other parts of the series here.

Personal physical care has got to one of the least popular aspects of a psychiatric nurse’s job, and the one that is most frequently delegated to healthcare support workers. It’s not supposed to be, but in reality it is. I personally found the personal physical care of patients awkward and embarrassing and avoided doing it if I could. (That’s not to say all nurses are as cowardly as me!)

On adult inpatient wards, physical care is not common, and you get out of the hang of doing it (which is why I always found it so awkward). But occasionally there are elderly or infirm patients; disabled people who might need some assistance with some aspects of personal care; patients with dementia or other cognitive difficulties; or patients who are catatonic. Staff might have to bathe patients, assist them with dressing or the toilet, give bed-baths, help with feeding, etc. It requires patience, professionalism and sensitivity to assist patients with personal care. It also requires experience, which is where I and other nurses struggle. The older, more experienced nurses and healthcare support workers have done this stuff for years and could dress a patient with their eyes closed. I, on the other hand, had little experience and felt nervous about it. Regardless, personal physical care is a part of the job and something all nurses have to do at some point.

It can be especially difficult with patients with cognitive difficulties who may resist attempts to help them. There is a duty of care to patients to maintain their physical health, and sometimes it may be necessary to restrain a patient in order to care for their physical state. This is very difficult and risky for everyone involved.

As well as personal care, nurses have numerous other physical health tasks to perform when required such as weighing patients, taking blood pressures, monitoring blood sugars, taking ECGs, etc. These are part of plethora of daily tasks that need doing. Psychiatric patients are at a very high risk of physical health issues such as obesity, high blood pressure, diabetes, etc: partly due to psychiatric medication and partly because of the poor lifestyle choices most psychiatric patients make. Nurses have to monitor physical health and refer any issues to the doctors.

(Are you getting to understand just what a diverse and busy job it is yet?)

Clerical duties take up a significant part of a psychiatric nurse’s working day. At the end of every shift an entry needs to be made in the case-notes of every patient on the books. The case-notes are mostly on computers now, which was a great development to those speedy typers like me, but many of the other staff struggled with this change and typing these entries takes an age for them. The entry made needs to give a description of how the patient has been throughout the shift; how their mental state has been, whether they’ve eaten, been off the ward, done anything risky, etc. Most of the decisions about care are based on these entries so they’re very important and need to be thorough. However… there are a number of problems with this. Firstly, not all staff make great entries. In fact some are downright illegible and say nothing useful. Secondly, it’s quite likely that the member of staff writing the entry hasn’t even laid eyes on their patients for the whole shift, being too busy. And thirdly, for some patients there is nothing at all to say as they’ve been exactly the same every single day for weeks. You might as well copy and paste the same thing day after day.

As well as making an entry at the end of every shift, staff are supposed to make an entry in these notes as soon as possible after any significant event. Someone rings about the patient, make an entry. The patient does something risky, make an entry. You spend some 1:1 time with a patient, make an entry. With 22 patients on the ward I was on and 5 staff per shift, I bet you can see that writing in case-notes takes up a lot of time, especially if you’re not very fast at typing.

The ward I worked on had a fantastic ward clerk. Without her the place would have fallen apart. But despite that, there was still a lot of clerical work to do, especially if it was her day off (usually falling to the shift leader). Numerous phone calls, filing, referral forms, etc. At least an hour of most days will be spent on purely clerical duties (not including the case-notes entries I just talked about). Just the general day-to-day things that need doing to keep the ward running smoothly.

Next time I’ll discuss the discharging of patients and mandatory training.